Idiopathic polyhydramnios and pregnancy outcomes: systematic review and meta‐analysis

To analyze pregnancy outcomes in singleton pregnancies with idiopathic polyhydramnios by a systematic review and meta-analysis of controlled trials.The research team utilized systematic review methodology to identify all items within published and grey literature resources. A medical librarian conducted a literature search of over twenty unique databases, collections and grey resources in the fall of 2019. Clinical team members conducted hand searches for specific journals' tables of contents. Multiple electronic databases were searched including MEDLINE, OVID, EBSCO, Cochrane collection, Science Citation Index and others from 1946 to 2019. Prospective and retrospective studies with a control group were included. Two authors independently reviewed all of the abstracts from the literature search. Inclusion criteria were: studies in English, singleton pregnancy, and idiopathic polyhydramnios determined by ultrasound amniotic fluid volume assessment (exclusions: diabetes, fetal anomaly, chromosome abnormality, alloimmunization, or intrauterine fetal infection).Twelve studies met inclusion criteria for a total of 2,392 patients with idiopathic polyhydramnios and 160,135 patients with normal amniotic fluid volume. Pregnancies complicated by idiopathic polyhydramnios had higher odds of neonatal death (OR 8.68; 95% CI 2.91-25.87), intrauterine fetal demise (OR 7.64; 95% CI 2.50-23.38), NICU admission (OR 1.94; 95% CI 1.45-2.59), 5 minute APGAR score less than 7 (OR 2.21; 95% CI 1.34-3.62), macrosomia (OR 2.93; 95% CI 2.39-3.59), malpresentation (OR 2.73; 95% CI 2.06-3.61), and cesarean delivery (OR 2.31; 95% CI 1.79-2.99).This study suggests that there is an increased risk of adverse outcomes in pregnancies complicated by idiopathic polyhydramnios and antenatal fetal surveillance, such as non-stress tests, should be considered as a part of management in these pregnancies. This article is protected by copyright. All rights reserved.